Attendance Review and Restoration Form
According to Texas State law, each student must be in attendance 90 percent of the days the class is offered. The implementation of the Attendance for Credit Program is to ensure that all students are in attendance 90 percent of the time a class is offered to certify successful accrual of credit or final grade.
FORM INSTRUCTIONS: Each area must be complete for the prescriptive plan to be valid
SCHOOL: / STUDENT NAME: / STUDENT ID:TEACHER(S)/GRADE LEVEL: / SUBJECT(S): / NUMBER OF DAYS ABSENT (E,U and O):
SPECIAL PROGRAMS (check all that apply):
☐Bilingual/ESL ☐ Section 504
☐ Special Education ☐Limited English Proficient / Has student been retained?
If yes indicate grade(s): ______
I. Prescriptive Plan
TIME OF DAY (check all that apply):☐ BEFORE SCHOOL ☐ EVENING SCHOOL
☐ AFTER SCHOOL ☐SATURDAY SCHOOL / ASSIGNMENT FOR FINAL GRADE OR CREDIT (course specific as determined by Attendance Committee – check all that apply):
☐ADDITIONAL ASSIGNMENTS FROM TEACHER ☐ TUTORIAL SESSION(S)
☐ INDEPENDENT PROJECT ☐SATURDAY SCHOOL
EXPLANATION OF REQUIRED ASSIGNMENT(S):
EXEMPT FROM PRINCIPAL’S PLAN DUE TO THE FOLLOWING:(Choose an item from the list and add Attachment A – Attendance for Credit Petition Form):
Board approved Extenuating Circumstances per FEC(Local)
☐ Days of Attendance
☐ Transfer/Migrant Student
☐ Best Interest Standard
☐Documentation
☐ Consideration of Control
☐ Student’s Academic Record
☐ Information from student or parent
II. Excessive Absence Contract
Student will:☐ Attend school daily
☐ Attend all classes on time
☐ Follow all school rules
☐ Complete all homework and classwork associated
with absences
☐ Meet regularly with ______
☐ Verify all illness absences by doctor’s note or
official verification
☐ Other: ______
Parent/Guardian will:
☐Cooperate with school officials
☐ Ensure student attends school
☐ Notify school when student is absent and provide
appropriate documentation
☐ Arrange for and keep appointments with
______
☐ Attend parent conferences when requested
☐ Attend parenting classes through:
______
☐ Other: ______/ In order to maximize the chances for educational success, the following agreement is entered into on ______.
Date
This agreement is between the Attendance Committee, ______,
Parent’s Name
and ______.
Student’s Name
A complete review of this agreement will take place on ______.
Date
______
Student’s signature Date
______
Parent/Guardian’s signature Date
______
Committee Member signature Campus Position Date
III. Final Grade/Credit Restoration
To be completed as students complete plan, at the end of school year (elementary/middle) or each semester (secondary/middle school semester courses)*
Subject / Start Date / End Date / # of Hours/Days / Assignment Complete / Grade/Credit Denied / Grade/CreditRestored
☐YES ☐ NO / ☐ / ☐
☐YES ☐ NO / ☐ / ☐
☐YES ☐ NO / ☐ / ☐
☐YES ☐ NO / ☐ / ☐
☐YES ☐ NO / ☐ / ☐
☐YES ☐ NO / ☐ / ☐
☐YES ☐ NO / ☐ / ☐
☐YES ☐ NO / ☐ / ☐
______
Attendance Administrator’s signature Date
______
Principal’s signature Date
*Student’s information to be included on the list of students who will restoreor be denied final grade/credit. This list should be approved and signed by the Principal and provided by the Principal to campus data personnel for coding in Chancery.